TY - JOUR
T1 - Same-day use of opioids and other central nervous system depressants amongst people who tamper with pharmaceutical opioids
T2 - A retrospective 7-day diary study
AU - Peacock, Amy
AU - Bruno, Raimondo
AU - Larance, Briony
AU - Lintzeris, Nick
AU - Nielsen, Suzanne
AU - Ali, Robert
AU - Dobbins, Timothy
AU - Degenhardt, Louisa
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Objective The aims were to determine: (i) quantity and frequency of same-day use of opioids with benzodiazepines and/or alcohol amongst people who regularly tamper with pharmaceutical opioids; and (ii) socio-demographic, mental health, harms and treatment profile associated with same-day use of high doses. Method The cohort (n = 437) completed a retrospective 7-day diary detailing opioid, benzodiazepine, and alcohol intake. Oral morphine equivalent (OME) units and diazepam equivalent units (DEU) were calculated, with >200 mg OME, >40 mg DEU and >4 standard alcoholic drinks (each 10 g alcohol) considered a “high dose”. Results One-half (47%) exclusively consumed opioids without benzodiazepines/alcohol; 26% had days of opioid use with and without benzodiazepines/alcohol; and 26% always used opioids and benzodiazepines/alcohol. Same-day use of opioids with benzodiazepines/alcohol typically occurred on 1–3 days in the past week. Six in ten (61%) participants reported high dose opioid use on at least one day; one in five (20%) reported high dose opioid and high dose benzodiazepine/alcohol use on at least one day. The latter group were more likely to use prescribed opioid substitution therapy, often alongside diverted pharmaceutical opioids. Socio-demographic and clinical profiles did not vary according to high dose opioid, alcohol and benzodiazepine use, and there was no association with harms. Conclusions Same-day use of opioids with benzodiazepines/alcohol, and high dose combinations, are common amongst people who tamper with pharmaceutical opioids. Assessment of concomitant benzodiazepine/alcohol use during opioid therapy, implementation of real-time prescription monitoring systems, and research to clarify upper safe limits for polydrug depressant use, are potential implications.
AB - Objective The aims were to determine: (i) quantity and frequency of same-day use of opioids with benzodiazepines and/or alcohol amongst people who regularly tamper with pharmaceutical opioids; and (ii) socio-demographic, mental health, harms and treatment profile associated with same-day use of high doses. Method The cohort (n = 437) completed a retrospective 7-day diary detailing opioid, benzodiazepine, and alcohol intake. Oral morphine equivalent (OME) units and diazepam equivalent units (DEU) were calculated, with >200 mg OME, >40 mg DEU and >4 standard alcoholic drinks (each 10 g alcohol) considered a “high dose”. Results One-half (47%) exclusively consumed opioids without benzodiazepines/alcohol; 26% had days of opioid use with and without benzodiazepines/alcohol; and 26% always used opioids and benzodiazepines/alcohol. Same-day use of opioids with benzodiazepines/alcohol typically occurred on 1–3 days in the past week. Six in ten (61%) participants reported high dose opioid use on at least one day; one in five (20%) reported high dose opioid and high dose benzodiazepine/alcohol use on at least one day. The latter group were more likely to use prescribed opioid substitution therapy, often alongside diverted pharmaceutical opioids. Socio-demographic and clinical profiles did not vary according to high dose opioid, alcohol and benzodiazepine use, and there was no association with harms. Conclusions Same-day use of opioids with benzodiazepines/alcohol, and high dose combinations, are common amongst people who tamper with pharmaceutical opioids. Assessment of concomitant benzodiazepine/alcohol use during opioid therapy, implementation of real-time prescription monitoring systems, and research to clarify upper safe limits for polydrug depressant use, are potential implications.
KW - Alcohol
KW - Benzodiazepine
KW - Concurrent use
KW - Opioid
KW - Overdose
KW - Polydrug abuse
UR - http://www.scopus.com/inward/record.url?scp=84989816909&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2016.07.003
DO - 10.1016/j.drugalcdep.2016.07.003
M3 - Article
C2 - 27430400
AN - SCOPUS:84989816909
SN - 0376-8716
VL - 166
SP - 125
EP - 133
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -